McCarthy Bridie
Catherine McAuley School of Nursing & Midwifery, University College Cork, Cork, Ireland.
J Clin Nurs. 2006 May;15(5):629-38. doi: 10.1111/j.1365-2702.2006.01366.x.
The research aims to explore how preceptors interpret, operationalize, document and teach person-centred care as they guide students within an acute surgical environment.
Person-centred care is a term that is widely used in the nursing literature; however, its interpretation in nursing practice remains virtually unexplored. This is of great significance to nurses in general but to Irish nurses in particular on whom this study is focused. As preceptor nurses have been identified as key people in the education of clinical students, it was considered important to explore how clinical preceptors promote person-centred care to current undergraduate nursing students.
Using a case study design and a qualitative approach, six preceptors were chosen to participate in this study. Data were collected by means of participant observation, review of nursing care records and semi-structured interviews. Data were analysed in two stages. The first stage involved the identification of themes. In the second stage data were analysed using a number of propositions to examine and explain what was gleaned from the data in the context of what was originally identified in the literature.
Findings highlighted that preceptors had a limited conception of person-centred care. Measures of care reflected the medical model of nursing. Beyond that, preceptors expressed care in terms of good manners or respectful etiquette. Preceptors also had limited appreciation of what learning entails and were sceptical about classroom theory other than what they considered essential for safe practice.
This study highlights that preceptors need both internal and external support to implement the changes advocated by the Commission in Nursing in 1998, the Nursing Education Forum in 2000, the Department of Health and Children in 2001 and An Bord Altranais in 2003.
Person-centred care is a relatively new concept in nursing and recommended for practice. Preceptors need facilitation with its implementation. In an effort to promote changes in the delivery of health care, it is suggested that university-based lecturers empower students to practice evidence-based nursing as students and subsequently as qualified nurses.
本研究旨在探讨带教老师在急性外科环境中指导学生时,如何理解、实施、记录并教授以患者为中心的护理。
以患者为中心的护理是护理文献中广泛使用的术语;然而,其在护理实践中的解读几乎尚未得到探讨。这对一般护士而言意义重大,对本研究聚焦的爱尔兰护士尤其如此。由于带教护士被视为临床学生教育中的关键人物,探讨临床带教老师如何向当前本科护理学生推广以患者为中心的护理被认为很重要。
采用案例研究设计和定性方法,选取六位带教老师参与本研究。通过参与观察、护理记录审查和半结构化访谈收集数据。数据分两个阶段进行分析。第一阶段涉及主题识别。第二阶段使用若干命题对数据进行分析,以在文献中最初确定的内容背景下检查和解释从数据中收集到的信息。
研究结果突出表明,带教老师对以患者为中心的护理的理解有限。护理措施反映了护理的医学模式。除此之外,带教老师以礼貌或尊重的礼仪来表达关怀。带教老师对学习的内涵也认识有限,并且除了他们认为对安全实践至关重要的内容外,对课堂理论持怀疑态度。
本研究强调,带教老师需要内部和外部支持,以实施1998年护理委员会、2000年护理教育论坛、2001年卫生与儿童部以及2003年爱尔兰护士及助产士管理局所倡导的变革。
以患者为中心的护理在护理领域是一个相对较新的概念,推荐应用于实践。带教老师在实施过程中需要得到协助。为促进医疗保健服务的变革,建议大学讲师使学生在学生时期以及随后成为合格护士后都能践行循证护理。